To evaluate the clinical efficacy of unrelated umbilical cord blood transplantation (UCBT) on the treatment of children with hematologic malignancies and nonmalignancies, between August 2001 and June 2004, 32 patients were transplanted by using unrelated umbilical cord blood supplied by Shandong Umbilical Cord Blood Bank. Out of them, 13 patients suffered from ALL, 9 from AML, 3 from AA, 3 from HAL, 2 from CML and 2 from NHL. The median age was 8 years (range 2-15), the median weight was 31.5 kg (range 14-55). All patients received ablative conditioning regiment according to the disease and the disease status. Conditioning regiments Cy/TBI were used for 4 patients and Bu/Cy for 21 patients, other for 7 patients. All patients received cyclosporin A and/or methotrexate for GVHD prophylaxis. The mean number of infused nuclear cells were 5.57 (2.16-12.3) x 10(7)/kg, CD34+ cells 1.78 (0.85-5.59) x 10(5). All of UCB units were tested for HLA-A, -B, and DRB1 using low and high resolution techniques. There were HLA-matched in 10, 5/6 in 16 and 4/6 in 6. The results showed that 20 out of 32 patients achieved complete engraftment. Median time of neutrophil > or = 0.5 x 10(9)/L, and platelet > or = 20 x 10(9)/L were 17 (9-38) and 42 (18-102) days respectively. The incidence of aGVHD II-IV and aGVHD III-IV were 35% and 15% respectively. After a median follow-up of 18 months (1.5-28.5), overall survival rate at one year was 59.4%, overall survival rate at two years was 40.6%. It is suggested that UCBT is promising for children patients who is lack of matched bone marrow donors.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation ; methods ; Cyclosporine ; administration & dosage ; Graft vs Host Disease ; prevention & control ; Hematologic Neoplasms ; mortality ; therapy ; Humans ; Methotrexate ; administration & dosage ; Survival Rate ; Transplantation Conditioning

Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Child ; Female ; Gene Expression Regulation, Neoplastic ; Hodgkin Disease ; genetics ; metabolism ; Humans ; Ki-1 Antigen ; metabolism ; Male ; Middle Aged ; PAX5 Transcription Factor ; metabolism ; Staining and Labeling ; methods ; Young Adult

Objecive To investigate the effects of Ezrin, Moesin and E-Cadherin on the invasion and metastasis of papillary thyroid carcinoma(PTC). Methods The 81 paraffln-embedded specimen of PTC treated in The Second Clinical College of Harbin Medical University from 2005 to 2008 were examined immunohistochemically for Ezrin, Moesin, and E-Cadherin. Normal thyroid tissues adjacent to cancer were control. The correlation of Ezrin, Moesin, and E-Cadherin expressions and clinical features of PTC,including gender, age, tumor size, invasion, lymph node metastasis, and TNM stage, was analyzed.Results Positive staining rates of Ezrin and Moesin in PTC were significantly higher than those in control (x2 were 61.691 and 57. 949, P ＜0.01, respectively). Positive staining rate of E-Cadherin in PTC was significantly lower than that in control (x2 = 64.241 ,P ＜ 0. 01 ) . The positive expression rates of Ezrin and Moesin in PTC incresed in the subgroups with age≥45 years,local invasion, lymph node metastasis and stage Ⅲ-Ⅳ, with significant difference respectively (P ＜ 0.01 ), while the positive expression rate of E-Cadherin in PTC significantly decreased ( P ＜ 0. 01 ). Conclusions The up-regulation expressions of Ezrin and Moesin and the down-regulation expression of E-Cadherin were associated with the invasion and metastasis of PTC. Combined detection of Ezrin, Moesin and E-Cadherin in PTC might served as an important predictor for the invasion, metastasis and prognosis of PTC.

Objective To report a case of foot hyalohyphomycosis due to Fusarium subglutinans. Methods Medical history was collected and physical examination performed for this patient.Biopsy samples were obtained from the inner side of right ankle of this patient and subjected to pathological examination. Discharge was collected from the lesions for direct microscopic examination and culture.Results A 72-year-old woman presented with an ulcer on the right foot for 3 years.Physical examination disclosed an ulcer,measuring 3 cm x 1.5 cm,with a moist surface and obvious tenderness,at the inner side of the right ankle.Proliferation of dusky-red granulomatous tissue was observed at the base of the ulcer.Pathological examination revealed necrotic granulomatous tissue and slender,septate and hyaline hypha-like structure in the superficial dermis with scattered infiltration of inflammatory cells.PAS staining showed sausage-like hypha and scattered orbicular-ovate spores.Microscopic examination of lesional discharge exhibited septate, branching and hyaline hypha.The isolated fungus was identified as Fusarium subglutinans by culture,and appeared to be highly sensitive to terbinafine,nystatin and amphotericin B.The lesion completely healed after 2 months of treatment with oral terbinafine (0.25 g,twice a day).Conclusions This is a case of foot hyalohyphomycosis due to Fusarium subglutinans,and terbinafine is effective for this condition.

Objective To explore the gene expression of human telomerase reverse transcriptase (hTERT)in childhood acute non- lymphocytic leukemia (ANLL) and its clinical implication. Methods Expression of hTERT mRNA was detected in HL - 60 leukemia cell line, 14 ANLL children and 11 healthy children by reverse transcriptase- polymerase chain reaction (RT- PCR). Results hTERT gene was expressed in HL-60 cell line, ANLL children (11/14) and healthy children (2/11). The expression of hTERT gene was observed in all subtypes of ANLL. Furthermore, there were statistically significant differences in expression levels of hTERT gene between children with ANLL and healthy children (t = 5.034 P = 0). Conclusions The up - regulation of gene expression of hTERT may play a very important role in the progression of children ANLL. The detection of hTERT expression may be a useful additional method for monitoring the state of illness.

OBJECTIVETo study the imaging findings outcome of the percutaneous laser disc decompression (PLDD) and evaluate the middle-term safety and efficacy of PLDD.

METHODSThe imaging data of 22 cases suffered cervical spondylosis or lumbar spondylosis and treated by PLDD more than 3 years were retrospectively reviewed. To observe the intervertebral space of the invasive disc and the intervertebral disc hernia before and after the operation on the lateral projection of X-ray and the axial view of the MRI. To make a statistical analysis of the data.

RESULTSThere was no obvious change of disc height involving the anterior disc height, the intermediate disc height and the posterior disc height after the PLDD at the final follow-up (P > 0.05). At last time follow-up, the Sagittal Index (SI) are 0.10 - 0.54 and 0.06 - 0.39 before and after the PLDD in the treatment of cervical vertebra. The statistical difference were significant (P < 0.05). In lumbar vertebra, the SI is 0 - 0.71 and 0 - 0.48 disc before and after the PLDD. The statistical difference were very significant (P < 0.01).

CONCLUSIONSThe PLDD will not destroy the intervertebral space of the cervical and lumbar vertebra obviously; moreover, it can effectively reduce the disk hernia. The PLDD is a safe and effective Mini-invasive surgery for cervical vertebra and lumbar vertebra diseases.

Adult ; Aged ; Decompression, Surgical ; methods ; Diskectomy, Percutaneous ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; diagnostic imaging ; surgery ; Laser Therapy ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Treatment Outcome

A 56-year-old female was admitted to Department of Gastroenterology at Peking Union Medical College Hospital with diarrhea for seven months, and abnormal liver function for six months. She had a history of type 1 diabetes. The main clinical manifestations were recurrent fatty diarrhea and abnormal liver function, accompanied by abdominal and retroperitoneal lymphadenopathy, elevated CA19-9 and CEA. Progressive impairment of hepatic synthetic function and shrinkage of liver developed in a short period of time. The pathology of liver biopsy suggested that nodular regeneration of hepatocytes was followed by hyperplasia of thin bile ducts after submassive necrosis. Intestinal mucosa biopsies were performed twice. The pathology showed that the intestinal villi were completely blunt, accompanied with crypt hyperplasia. Goblet cells disappeared with reduced mucin. Paneth cells were barely seen without intraepithelial infiltration of lymphocytes. Rifaximin was not effective, while glucocorticoids improved clinical situation. The diagnosis of autoimmune enteropathy was finally confirmed by multidisciplinary team including departments of gastroenterology, pathology, endocrinology, hematology, infectious diseases, and rheumatology. With the administration of glucocorticoid and sirolimus, diarrhea relieved and liver function returned to normal.

To evaluate the clinical outcomes of loupe-assisted intussusception vasoepididymostomy (VE) in the treatment of epididymal obstructive azoospermia (EOA), we retrospectively analyzed data from 49 patients with EOA who underwent two-suture longitudinal intussusception vasoepididymostomy (LIVE) between 2000 and 2007. The data included the surgical method, postoperative motile sperm count per ejaculation, percentage of progressive motile sperm and patency and pregnancy outcomes. There were a total of 49 men undergoing scrotal exploration, and epididymal obstruction was found in all cases. Bilateral or unilateral anastomoses were performed in 40 and 6 men, respectively. The postoperative courses of 42 patients were followed up for more than 6 months, and the courses of 38 patients were followed up for more than 1 year. The overall patency and pregnancy rates were 71.4% and 26.3%, respectively. Moreover, progressive motile sperm was more frequently present in those patients who had undergone anastomosis at cauda than at corpus or caput. Pregnancy was achieved only in those patients who had undergone anastomosis at least on one side of the cauda epididymis. We think that the loupe-assisted method, with a lower overall cost and a simplified surgical procedure, can achieve satisfactory patency outcomes and pregnancy results. Data from this paper also suggest that paternity outcomes occur more frequently after anastomoses at cauda than at corpus or caput.
Adult ; Anastomosis, Surgical ; Azoospermia ; etiology ; pathology ; surgery ; Constriction, Pathologic ; complications ; pathology ; surgery ; Ejaculatory Ducts ; pathology ; surgery ; Epididymis ; pathology ; surgery ; Humans ; Male ; Microsurgery ; methods ; Retrospective Studies ; Sperm Motility ; Treatment Outcome ; Vasovasostomy ; methods

OBJECTIVESTo discuss the therapeutic choices of erectile dysfunction (ED) and to improve the therapeutic efficacy for different ED cases.

METHODSTwo hundred and twenty-seven patients with ED were treated repectively with psychological treatment(31 cases), oral testosterone(30 cases), Viagra(121 cases), psychological treatment + Viagra (16 cases), intraurethral PGE1 (8 cases) and intracavemous injection(21 cases).

RESULTSAmong those ED patients, 142 (62.6%) cases reported improved erections after they had undergone above-mentioned therapies. The improved patients include 12 cases(38.7%) with psychological treatment, 9 cases (30.0%) with oral testosterone, 91 cases (75.2%) with Viagra, 13 cases (81.3%) with psychological and Viagar, 2 cases (25.0%) with intraurethral PGE1 and 21 cases (71.4%) with intracavemous injection.

CONCLUSIONSED is a highly individualized disease, therapeutic choices of ED based on patient's situation can benefit those patients.

Administration, Oral ; Adult ; Aged ; Alprostadil ; therapeutic use ; Combined Modality Therapy ; Erectile Dysfunction ; drug therapy ; therapy ; Humans ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Psychotherapy ; Purines ; Sildenafil Citrate ; Sulfones ; Testosterone ; therapeutic use ; Treatment Outcome ; Vasodilator Agents ; therapeutic use